The DOI matches its Crossref record; 61 of the 61 references it cites were found in a registry or an index.
Prognostic Factors in High-Grade Osteosarcoma of the Extremities or Trunk: An Analysis of 1,702 Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols
Abstract
PURPOSE: To define prognostic factors for response and long-term outcome for a wide spectrum of osteosarcomas, extending well beyond those of the typical young patient with seemingly localized extremity disease. PATIENTS AND METHODS: A total of 1,702 consecutive newly diagnosed patients with high-grade osteosarcoma of the trunk or limbs registered into the neoadjuvant studies of the Cooperative Osteosarcoma Study Group before July 1998 were entered into an analysis of demographic, tumor-related, and treatment-related variables, response, and survival. The intended therapeutic strategy included preoperative and postoperative chemotherapy with multiple agents as well as surgery of all operable lesions. RESULTS: Axial tumor site, male sex, and a long history of symptoms were associated with poor response to chemotherapy in univariate and multivariate analysis. Actuarial 10-year overall and event-free survival rates were 59.8% and 48.9%. Among the variables assessable at diagnosis, patient age (actuarial 10-year survival ≥ 40, 41.6%; < 40, 60.2%; P = .012), tumor site (axial, 29.2%; limb, 61.7%; P < .0001), and primary metastases (yes, 26.7%; no, 64.4%; P < .0001), and for extremity osteosarcomas, also size (≥ one third, 52.5%; < one third, 66.7%; P < .0001) and location within the limb (proximal, 49.3%; other, 63.9%; P < .0001), had significant influence on outcome. Two additional important prognostic factors were treatment related: response to chemotherapy (poor, 47.2%; good, 73.4%; P < .0001) and the extent of surgery (incomplete, 14.6%; macroscopically complete, 64.8%; P < .0001). All factors except age maintained their significance in multivariate testing, with surgical remission and histologic response emerging as the key prognostic factors. CONCLUSION: Tumor site and size, primary metastases, response to chemotherapy, and surgical remission are of independent prognostic value in osteosarcoma.
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“These strata were based on studies showing that a shorter relapse-free interval and older age are prognostic for shorter OS in patients with osteosarcoma.”
From Lenvatinib Plus Ifosfamide and Etoposide in Children and Young Adults With Relapsed Osteosarcoma (2024) · cites this paper as [33]
In the citing paper
“In addition, patients with unresectable primary or metastatic disease at diagnosis and those with disease relapse have extremely poor outcomes 2,126 .”
From Osteosarcoma (2022) · cites this paper as [2]
In the citing paper
“Otherwise, intralesional or marginal resections increase local recurrence rate, which is associated with reduced overall survival 2,134 .”
From Osteosarcoma (2022) · cites this paper as [2]
Citations
Cites
Nonparametric Estimation from Incomplete Observations
Kaplan, E. L., & Meier, P. (1992) · Springer series in statistics · doi:10.1007/978-1-4612-4380-9_25 · Cited by 45,239
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793
Nonparametric Estimation from Incomplete Observations
Kaplan, E. L., & Meier, P. (1958) · Journal of the American Statistical Association · doi:10.1080/01621459.1958.10501452 · Cited by 39,158
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297
Evaluation of survival data and two new rank order statistics arising in its consideration.
Mantel, N. (1966) · PubMed · Cited by 7,516
Plackett, R. L., & Cox, D. R. (1971) · Journal of the Royal Statistical Society Series A (General) · doi:10.2307/2344247 · Cited by 2,274
Underrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment Trials
Hutchins, L. F., Unger, J. M., Crowley, J. J., Coltman, C. A., & Albain, K. S. (1999) · New England Journal of Medicine · doi:10.1056/nejm199912303412706 · Cited by 2,171
Link, M. P., Goorin, A. M., Miser, A. W., Green, A. A., Pratt, C. B., Belasco, J. B., Pritchard, J., Malpas, J. S., Baker, A. R., Kirkpatrick, J. A., et al. (1986) · New England Journal of Medicine · doi:10.1056/nejm198606193142502 · Cited by 1,203
Rosen, G., Caparros, B., Huvos, A. G., Kosloff, C., Nirenberg, A., Cacavio, A., Marcove, R. C., Lane, J. M., Mehta, B. M., & Urban, C. (1982) · Cancer · doi:10.1002/1097-0142(19820315)49:6 · Cited by 1,082
Chemotherapy for nonmetastatic osteogenic sarcoma: the Memorial Sloan-Kettering experience.
Meyers, P. A., Heller, G., Healey, J. H., Huvos, A. G., Lane, J. M., Marcove, R. C., Applewhite, A., Vlamis, V., & Rosen, G. (1992) · Journal of Clinical Oncology · doi:10.1200/jco.1992.10.1.5 · Cited by 675
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Livin and Bcl-2 expression in high-grade osteosarcoma
Nedelcu, T., Kubista, B., Koller, A., Sulzbacher, I., Mosberger, I., Arrich, F., Trieb, K., Kotz, R. I., & Toma, C. D. (2007) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-007-0276-z · Cited by 69
“These include tumor size and site, primary metastases and, most importantly, the response to preoperative neoadjuvant chemotherapy (Bielack et al. 2002).”
BackgroundSelf-citationHan, J., Yong, B., Luo, C., Tan, P., Peng, T., & Shen, J. (2012) · World Journal of Surgical Oncology · doi:10.1186/1477-7819-10-37 · Cited by 69
“However, all the studies before [8,26,27] do not stratify for these differences, so the effect of age on ALP levels can not be evaluated.”
BackgroundResultThe role of FDG PET/CT in patients treated with neoadjuvant chemotherapy for localized bone sarcomas
Palmerini, E., Colangeli, M., Nanni, C., Fanti, S., Marchesi, E., Paioli, A., Picci, P., Cambioli, S., Donati, D. M., Cevolani, L., et al. (2016) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-016-3509-z · Cited by 69
What's New in Musculoskeletal Oncology
WEBER, K. L. (2005) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.e.00257 · Cited by 69
Pediatric cancers in the new millennium: dramatic progress, new challenges.
McGregor, L. M., Metzger, M. L., Sanders, R. P., & Santana, V. M. (2007) · PubMed · Cited by 69
Prognostic value of indoleamine 2,3-dioxygenase expression in high grade osteosarcoma
Urakawa, H., Nishida, Y., Nakashima, H., Shimoyama, Y., Nakamura, S., & Ishiguro, N. (2009) · Clinical & Experimental Metastasis · doi:10.1007/s10585-009-9290-7 · Cited by 69
“In this study, population age over 20 years was a significant prognostic predictor for decreased overall survival, and older age was shown to be a prognostic factor of osteosarcoma in previous studies [1, 2].”
ResultKong, C., Byun, B. H., Lim, I., Choi, C. W., Lim, S. M., Song, W. S., Cho, W. H., Jeon, D., Koh, J., Yoo, J. Y., et al. (2013) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-013-2344-8 · Cited by 68
Wang, S., Li, H., Li, B., Xie, T., Zhu, T., Sun, L., Ren, H., & Ye, Z. (2016) · International Immunopharmacology · doi:10.1016/j.intimp.2016.05.016 · Cited by 67
Salah, S. H., Lewin, J. H., Amir, E., & Razak, A. A. (2018) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2018.05.007 · Cited by 68
Haghiralsadat, F., Amoabediny, G., Naderinezhad, S., Zandieh‐Doulabi, B., Forouzanfar, T., & Helder, M. N. (2018) · International Journal of Nanomedicine · doi:10.2147/ijn.s150017 · Cited by 70
Osteosarcoma: Current Concepts and Evolutions in Management Principles
Pilavaki, P., Ardakani, A. H. G., Gikas, P. D., & Constantinidou, A. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12082785 · Cited by 70
“originally present with macroscopic metastatic disease, whilst the lungs are the most common site of metastases [5,8].”
BackgroundHoudek, M. T., Wagner, E. R., Wilke, B. K., Wyles, C. C., Taunton, M. J., & Sim, F. H. (2015) · The Knee · doi:10.1016/j.knee.2015.08.010 · Cited by 67
“Although technically complex, limb-salvage surgery has become more common for treatment of periarticular tumors of the knee due tomany recent innovations, including advances in adjuvant treatments, biomaterials, surgical techniques and radiological imaging modalities [1–5].”
BackgroundYoun, P., Milano, M. T., Constine, L. S., & Travis, L. B. (2014) · Cancer · doi:10.1002/cncr.28733 · Cited by 67
“Chemosensitive sarcomas (5536 cases) were defined as Ewing sarcoma (International Classification of Diseases for Oncology 3 Edition [ICD-O-3] code 9260), osteosarcoma (codes 9180-9200), and rhabdomyosarcoma (codes 8900-8920), types for which the use of aggressive neoadjuvant or adjuvant chemotherapy has been widely ac…”
BackgroundMultimodality treatment of osteosarcoma: Radiation in a high‐risk cohort
Mahajan, A., Woo, S. Y., Kornguth, D. G., Hughes, D. P. M., Huh, W. W., Chang, E. L., Herzog, C. E., Pelloski, C. E., & Anderson, P. M. (2008) · Pediatric Blood & Cancer · doi:10.1002/pbc.21451 · Cited by 67
“primary disease, develop metastatic disease [3,4].”
Thiele, O. C., Freier, K., Bacon, C., Egerer, G., & Hofele, C. (2008) · British Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.bjoms.2008.03.010 · Cited by 68
Cho, W. H., Song, W. S., Jeon, D., Kong, C., Kim, M. S., Lee, J. A., Yoo, J. Y., Kim, J. D., & Lee, S. (2009) · Annals of Surgical Oncology · doi:10.1245/s10434-009-0825-6 · Cited by 67
18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors
London, K., Stege, C. A. M., Cross, S. F., Onikul, E., Graf, N. S., Kaspers, G. J. L., Dalla‐Pozza, L., & Howman-Giles, R. B. (2011) · Pediatric Radiology · doi:10.1007/s00247-011-2278-x · Cited by 67
“Important considerations for determining prognosis and subsequent management include tumor histology and grade, the location of the primary tumor, the extent of loco-regional andmetastatic disease, and response to chemotherapy [2].”
BackgroundKawano, M., Tanaka, K., Itonaga, I., Iwasaki, T., Miyazaki, M., Ikeda, S., & Tsumura, H. (2016) · Oncology Letters · doi:10.3892/ol.2016.4175 · Cited by 67
“The standard treatment for metastatic osteosarcoma is systemic combination chemotherapeutics (2); however, it would be beneficial if cancer patients could elicit tumor‑specific immunity that would control or slow the growth of residual tumor cells.”
The Current and Future Therapies for Human Osteosarcoma
Lamplot, J. D., Denduluri, S. K., Qin, J., Li, R., Liu, X., Zhang, H., Chen, X., Wang, N., Pratt, A., Shui, W., et al. (2013) · Current Cancer Therapy Reviews · doi:10.2174/1573394711309010006 · Cited by 67
“Critical determinants of long-term survival in patients presenting with metastatic disease are location of disease and surgical resectability, number of metastases at diagnosis, location of metastases, surgical remission and tumor necrosis following neoadjuvant chemotherapy [9-12].”
BackgroundInfluentialHippo/YAP signaling pathway is involved in osteosarcoma chemoresistance
Wang, D., Wu, Y., Huang, J., Wang, W., Xu, M., Jia, J., Han, G., Mao, B., & Bi, W. (2016) · 癌症：英文版 · doi:10.1186/s40880-016-0109-z · Cited by 68
Sun, Y., Liu, L., Wang, Y., He, A., Hu, H., Zhang, J. J., Han, M., & Huang, Y. (2019) · OncoTargets and Therapy · doi:10.2147/ott.s172909 · Cited by 66
Targeting CD44 by CRISPR-Cas9 in Multi-Drug Resistant Osteosarcoma Cells
Zheng, X. W., Wan, J., Nur, A. A., Dou, P., Mankin, H. J., Liu, T., & Ouyang, Z. (2018) · Cellular Physiology and Biochemistry · doi:10.1159/000495714 · Cited by 64
Bone Microvasculature: Stimulus for Tissue Function and Regeneration
Lee, E. J., Jain, M., & Alimperti, S. (2020) · Tissue Engineering Part B Reviews · doi:10.1089/ten.teb.2020.0154 · Cited by 66
“74 Postsurgical effects of these treatments include the development of pathological fracture causing pain, immobility, and local recurrence.”
Chen, B., Zeng, Y., Liu, B., Lu, G., Xiang, Z., Chen, J., Yan, Y., Zuo, Z., Lin, Y., & Ma, J. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.672024 · Cited by 68
“Osteosarcoma is themostprevalent formofbonecancerandmainly occurs in children and adolescents (1), which is predominantly derived from the terminus of the long bones, including distal femur (43%), proximal tibias (23%), and proximal humor (10%) (2).”
BackgroundThe role of interferons in the treatment of osteosarcoma
Whelan, J. S., Patterson, D., Perisoglou, M., Bielack, S., Marina, N. M., Smeland, S., & Bernstein, M. L. (2009) · Pediatric Blood & Cancer · doi:10.1002/pbc.22136 · Cited by 66
“Patients with good response to preoperative chemotherapy (>90% necrosis) experience a 5-year survival of 75–80% compared with 45–55% for those with a poor response ( 90% necrosis) [3,4].”
BackgroundSelf-citationSHANGGUAN, W.-J., Li, H., & ZHANG, Y.-H. (2013) · Oncology Reports · doi:10.3892/or.2013.2815 · Cited by 66
Pazopanib in relapsed osteosarcoma patients: report on 15 cases
Longhi, A., Paioli, A., Palmerini, E., Cesari, M., Abate, M. E., Setola, E., Spinnato, P., Donati, D. M., Hompland, I., & Boye, K. (2018) · Acta Oncologica · doi:10.1080/0284186x.2018.1503714 · Cited by 65
“[2] Langberg MK, Berglund-Nord C, Cohn-Cedermark G, et al.”
BackgroundOsteosarcoma in very young children
Kager, L., Zoubek, A., Dominkus, M., Lang, S., Bodmer, N., Jundt, G., Klingebiel, T., Jürgens, H., Gadner, H., Bielack, S., et al. (2010) · Cancer · doi:10.1002/cncr.25287 · Cited by 65
“However, the number of primaries affecting the proximal humerus was higher than expected for osteosarcoma in general.(22) This observation strengthens preliminary findings from earlier investigations on smaller cohorts.”
BackgroundMethodResultInfluentialSelf-citationQuartuccio, N., Treglia, G., Salsano, M., Mattoli, M. V., Muoio, B., Piccardo, A., Lopci, E., & Cistaro, A. (2013) · Radiology and Oncology · doi:10.2478/raon-2013-0017 · Cited by 65
Nishida, Y., Knudson, W., Knudson, C. B., & Ishiguro, N. (2005) · Experimental Cell Research · doi:10.1016/j.yexcr.2005.03.026 · Cited by 65
“Axial lesions have an inferior outcome [35, 36] and the presence of clinically detectable primary metastatic disease correlates with poor prognosis [35, 37].”
BackgroundGuenther, L. M., Rowe, R. G., Acharya, P. T., Swenson, D. W., Meyer, S. C., Clinton, C. M., Guo, D., Sridharan, M., London, W. B., Grier, H. E., et al. (2017) · Pediatric Blood & Cancer · doi:10.1002/pbc.26896 · Cited by 66
Staging of Bone and Soft-tissue Sarcomas
Steffner, R. J., & Jang, E. S. (2018) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-17-00055 · Cited by 65
Novel Tumor Suppressor lncRNA Growth Arrest-Specific 5 (GAS5) In Human Cancer
Yu, Y., & Hann, S. S. (2019) · OncoTargets and Therapy · doi:10.2147/ott.s221305 · Cited by 67
“Osteosarcoma is the most common primary malignant bone tumor developing in childhood and adolescence with poor outcome and the 5-year OS rate of patients with metastatic osteosarcoma is less than 20%.(109) GAS5 was down-regulated in MG-63 and OS732 osteosarcoma cells compared to normal hFOB1.”
BackgroundTherapeutic Targets for Bone and Soft-Tissue Sarcomas
Miwa, S., Yamamoto, N., Hayashi, K., Takeuchi, A., Igarashi, K., & Tsuchiya, H. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20010170 · Cited by 66
Involvement and Clinical Aspects of MicroRNA in Osteosarcoma
Kumar, R., Boro, A., & Fuchs, B. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17060877 · Cited by 64
Zhao, S., Su, Y., Duan, J., Qiu, Q., Ge, X., Wang, A., & Yin, Y. (2019) · Journal of bone oncology · doi:10.1016/j.jbo.2019.100263 · Cited by 63
“Presently, prognosis of non-metastatic osteosarcoma is determined largely based on histological response and completeness of resection [9]; magnetic resonance imaging serves an adjunct role in assessing treatment response, generally on the basis of imaging appearance on fluid sensitive and post-contrast imaging sequen…”
BackgroundWang, Y., Jia, L.-S., Yuan, W., Zhao, W., Wang, H.-B., Xu, T., Sun, J., Cheng, K.-F., & Shi, J.-G. (2015) · Europe PMC (PubMed Central) · Cited by 63
Liu, T., Fang, X.-C., Ding, Z., Sun, Z.-G., Sun, L.-M., & Wang, Y.-L. (2015) · FEBS Open Bio · doi:10.1016/j.fob.2015.08.002 · Cited by 64
Osteosarcoma Lung Metastases Detection and Principles of Multimodal Therapy
Carrle, D., & Bielack, S. (2009) · Cancer treatment and research · doi:10.1007/978-1-4419-0284-9_8 · Cited by 63
Self-citationSurvivin as a Prognostic Factor for Osteosarcoma Patients
Osaka, E., Suzuki, T., Osaka, S., Yoshida, Y., Sugita, H., Asami, S., Tabata, K., Hemmi, A., Sugitani, M., Nemoto, N., et al. (2006) · ACTA HISTOCHEMICA ET CYTOCHEMICA · doi:10.1267/ahc.06005 · Cited by 63
“Current treatment protocols for osteosarcoma include wide surgical resection of the primary lesion and multidrug chemotherapy [4, 19].”
BackgroundSmith, G., Johnson, G. D., Grimer, R., & Wilson, S. (2011) · Annals of The Royal College of Surgeons of England · doi:10.1308/147870811x13137608455055 · Cited by 63
HaDuong, J. H., Martin, A. A., Skapek, S. X., & Mascarenhas, L. (2014) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2014.09.012 · Cited by 69
Tumour response prediction by diffusion-weighted MR imaging: Ready for clinical use?
Heijmen, L., Verstappen, M. C. H. M., ter Voert, E. E. G. W., Punt, C. J. A., Oyen, W. J. G., de Geus‐Oei, L., Hermans, J. J., Heerschap, A., & van Laarhoven, H. W. M. (2012) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2011.12.008 · Cited by 62
The miRNAs in the pathgenesis of osteosarcoma
Fu, Q. (2012) · Frontiers in bioscience · doi:10.2741/4142 · Cited by 61
“The inhibition of miR-21 significantly reduced the lung metastasis of breast cancer cellsin vivo (43).”
BackgroundHip transposition as a universal surgical procedure for periacetabular tumors of the pelvis
Gebert, C., Gosheger, G., & Winkelmann, W. (2008) · Journal of Surgical Oncology · doi:10.1002/jso.21212 · Cited by 62
Self-citationHasei, J., Sasaki, T., Tazawa, H., Osaki, S., Yamakawa, Y., Kunisada, T., Yoshida, A., Hashimoto, Y., Onishi, T., Uno, F., et al. (2013) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.mct-12-0869 · Cited by 70
The role of pharmacogenetics in the treatment of osteosarcoma
Vos, H. I., Coenen, M. J. H., Guchelaar, H., & Loo, D. M. W. M. T. (2016) · Drug Discovery Today · doi:10.1016/j.drudis.2016.06.022 · Cited by 61
Osteogenic Sarcoma: Systemic Chemotherapy Options for Localized Disease
Harrison, D. J., & Schwartz, C. L. (2017) · Current Treatment Options in Oncology · doi:10.1007/s11864-017-0464-2 · Cited by 63
Current Treatment Considerations for Osteosarcoma Metastatic at Presentation
Tsukamoto, S., Errani, C., Angelini, A., & Mavrogenis, A. F. (2020) · Orthopedics · doi:10.3928/01477447-20200721-05 · Cited by 59
Surgical management and outcome of osteosarcoma patients with unilateral pulmonary metastases
Su, W. T., Chewning, J. H., Abramson, S., Rosen, N. S., Gholizadeh, M., Healey, J. H., Meyers, P. A., & LaQuaglia, M. P. (2004) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2003.11.030 · Cited by 62
Pourebrahim, R., Zhang, Y., Liu, B., Gao, R., Xiong, S., Lin, P. P., McArthur, M. J., Ostrowski, M. C., & Lozano, G. (2017) · Genes & Development · doi:10.1101/gad.304972.117 · Cited by 62
“We chose to use the osteosarcoma model because (1) it is known that loss or mutation of p53 is sufficient to generate osteosarcomas, and (2) metastasis to the lung is common in oste- osarcomas (Bielack et al. 2002).”
MethodCytotoxic T-lymphocyte Antigen-4 Polymorphisms and Susceptibility to Osteosarcoma
Liu, Y., He, Z., Feng, D., Shi, G., Gao, R., Wu, X., Song, W., & Yuan, W. (2011) · DNA and Cell Biology · doi:10.1089/dna.2011.1269 · Cited by 60
“Treatment of patients with osteosarcoma was transformed in the 1980s and 1990s with advances in chemotherapy and orthopedic surgical techniques, leading to long-term survival rates that now approach 70% (Bielack et al. , 2002).”
Bone Cancer, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology
Biermann, J. S., Hirbe, A. C., Ahlawat, S., Bernthal, N. M., Binitie, O. T., Boles, S. G., Brigman, B. E., Callan, A. K., Cipriano, C. A., Cranmer, L. D., et al. (2025) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2025.0017 · Cited by 67
18F-FDG PET response to neoadjuvant chemotherapy for Ewing sarcoma and osteosarcoma are different
Gaston, C. L., Bella, C. D., Slavin, J., Hicks, R. J., & Choong, P. (2011) · Skeletal Radiology · doi:10.1007/s00256-011-1096-4 · Cited by 61
Baumhoer, D., Zillmer, S., Unger, K., Rosemann, M., Atkinson, M. J., Irmler, M., Beckers, J., Siggelkow, H., von Luettichau, I., Jundt, G., et al. (2012) · Cancer Genetics · doi:10.1016/j.cancergen.2012.03.001 · Cited by 61
Imran, H., Enders, F., Krailo, M., Sim, F. H., Okuno, S. H., Hawkins, D. S., Neglia, J. P., Randall, R. L., Womer, R. B., Mascarenhas, L., et al. (2009) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.h.00449 · Cited by 61
“In addition, the patient had to have received neoadjuvant chemotherapy with (1) doxorubicin, cisplatin, and high-dose methotrexate with or without ifosfamide and with or without muramyl tripeptide phosphatidyl ethanolamine either in, or according to the previously published protocol of, the COG Phase-III Intergroup St…”
MethodResultHsu, Y.-N., Shyu, H.-W., Hu, T.-W., Yeh, J.-P., Lin, Y., Lee, L.-Y., Yeh, Y., Dai, H.-Y., Perng, D., Su, S., et al. (2018) · Food and Chemical Toxicology · doi:10.1016/j.fct.2017.12.062 · Cited by 61
Nugent, M. (2015) · Advances in experimental medicine and biology · doi:10.1007/978-3-319-23730-5_11 · Cited by 60
The lnc RNA HNF 1A‐ AS 1 is a negative prognostic factor and promotes tumorigenesis in osteosarcoma
Cai, L., Lv, J., Zhang, Y., Li, J., Wang, Y., & Yang, H. (2017) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.12944 · Cited by 60
“Although wide tumour excision is effective on primary disease, in addition to currently widely adopted adjuvant chemotherapy and radiotherapy on metastatic lesions, the cure rate of osteosarcoma patients remain dismal [3, 4].”
BackgroundmiRNAs as potential game-changers in bone diseases: Future medicinal and clinical uses
Doghish, A. S., Elballal, M. S., Elazazy, O. E., Elesawy, A. E., Shahin, R. K., Midan, H. M., Sallam, A.-A. M., Elbadry, A. M. M., Mohamed, A. K. I., Ishak, N. W., et al. (2023) · Pathology - Research and Practice · doi:10.1016/j.prp.2023.154440 · Cited by 60
Li, B., Zhu, X., Sun, L., Li, Y., Zhang, J., Li, H., & Ye, Z. (2014) · Oncotarget · doi:10.18632/oncotarget.2505 · Cited by 60
“Despite intensification of conventional chemotherapy and surgery, the 5-year survival rate for patients with localized tumor have reached a plateau at about 65% [2], and it is 20% for patients with relapsed tumors or metastasis [3].”
BackgroundExpression and prognostic relevance of PRAME in primary osteosarcoma
Tan, P., Zou, C., Yong, B., Han, J., Zhang, L., Su, Q., Yin, J., Wang, J., Huang, G., Peng, T., et al. (2012) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2012.02.110 · Cited by 60
Parashar, S., Cheishvili, D., Arakelian, A., Hussain, Z., Tanvir, I., Khan, H. A., Moshe Szyf, A., & Rabbani, S. A. (2015) · Cancer Medicine · doi:10.1002/cam4.386 · Cited by 60
Prognostic significance of early lymphocyte recovery in pediatric osteosarcoma
Moore, C. E., Eslin, D. E., Levy, A., Roberson, J. R., Giusti, V., & Sutphin, R. M. (2010) · Pediatric Blood & Cancer · doi:10.1002/pbc.22673 · Cited by 60
“This survivor however only had metastatic disease to the lungs, which has been shown to have a superior outcome versus bony metastasis [3,6] Whether host immune functions play a role in the site of metastatic disease is unclear and would require larger studies for evaluation.”
BackgroundResultZhang, L., Wang, Y., Li, X., Xia, X., Li, N., He, R., He, H., Han, C., & Zhao, W. (2017) · Neoplasia · doi:10.1016/j.neo.2017.08.008 · Cited by 59
Carbon ion radiotherapy for inoperable pediatric osteosarcoma
Mohamad, O., the Working Group for Bone and Soft Tissue Sarcoma, Imai, R., Kamada, T., Nitta, Y., & Araki, N. (2018) · Oncotarget · doi:10.18632/oncotarget.25165 · Cited by 61
“In the Cooperative Osteosarcoma Study (COSS) Group where patients received pre-operative and post-operative chemotherapy and surgery for operable lesions, overall survival in truncal osteosarcomas was 34% compared to 65% in all patients [2].”
BackgroundAhmed, G., Zamzam, M., Kamel, A., Ahmed, S., Salama, A., Zaki, I., Kamal, N., & Elshafiey, M. M. (2018) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2018.06.019 · Cited by 60
Tumor size as a predictor of outcome in pediatric non‐metastatic osteosarcoma of the extremity
Kaste, S. C., Liu, T., Billups, C. A., Daw, N. C., Pratt, C. B., & Meyer, W. H. (2004) · Pediatric Blood & Cancer · doi:10.1002/pbc.20077 · Cited by 60
“However, the presence or absence of metastatic disease and the histologic response to preoperative chemotherapy are the factors most highly correlated with the outcome of extremity osteosarcoma at present, and only the former can be assessed at the time of diagnosis [2,6,8].”
BackgroundHigh Expression of HULC Is Associated with Poor Prognosis in Osteosarcoma Patients
Uzan, V. R. M., Lengert, A. V. H., Boldrini, É., Penna, V., Scapulatempo‐Neto, C., Scrideli, C. A., Filho, A. P. D. M., Cavalcante, C. E. B., de Oliveira, C. Z., Lopes, L. F., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0156774 · Cited by 59
“approximately 40% will progress to metastasis in later stages during treatment [2,3].”
BackgroundWhat Are the Factors That Affect Survival and Relapse After Local Recurrence of Osteosarcoma?
Takeuchi, A., Lewis, V. O., Satcher, R. L., Moon, B. S., & Lin, P. P. (2014) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-014-3759-7 · Cited by 59
Bishop, M. W., Chang, Y., Krailo, M. D., Meyers, P. A., Provisor, A. J., Schwartz, C. L., Marina, N. M., Teot, L. A., Gebhardt, M. C., Gorlick, R., et al. (2016) · Pediatric Blood & Cancer · doi:10.1002/pbc.26034 · Cited by 52
“The long-term survival rate for localized osteosarcoma has remained around 65–70% for decades;[1,2,20–22] to date, histologic necrosis remains the only consistently significant prognostic factor for survival for patients with localized disease.[3,6,10, 12,20,23] However, our results demonstrate an inverse relationship…”
BackgroundZhao, M.-D., HUANG, J., Gui, K., Xiong, M., Cai, G., Ji, X., Wang, K., LIU, D., Zhang, X., & Yin, W. (2014) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2014.1963 · Cited by 58
“Osteosarcoma is the most common human primary malignant bone tumor in children and adolescents (1).”
Ye, F., Tian, L., Zhou, Q., & Feng, D. (2019) · Gene · doi:10.1016/j.gene.2019.144093 · Cited by 58
Serra, M., Pasello, M., Manara, M. C., Scotlandi, K., Ferrari, S., Bertoni, F., Mercuri, M., Alvegård, T. A., Picci, P., Bacci, G., et al. (2006) · International Journal of Oncology · doi:10.3892/ijo.29.6.1459 · Cited by 58
Surgical options and outcomes in bone sarcoma
Wafa, H., & Grimer, R. J. (2006) · Expert Review of Anticancer Therapy · doi:10.1586/14737140.6.2.239 · Cited by 58
Results of the Scandinavian Sarcoma Group XIV protocol for classical osteosarcoma
Smeland, S., Bruland, Ø. S., Hjorth, L., Brosjö, O., Bjerkehagen, B., Österlundh, G., Jakobson, Å. M., Hall, K. S., Monge, O. R., Björk, O., et al. (2011) · Acta Orthopaedica · doi:10.3109/17453674.2011.566141 · Cited by 58
“With this strategy, 5-year overall survival rates of 70% have been reported for patients aged ≤ 40 years with non-metastatic, extremity localized osteosarcoma at diagnosis (Bielack et al. 2002, Smeland et al. 2003, Ferrari et al. 2005).”
BackgroundYang, S., Zhou, Y., Sun, Y., Wang, Y., Yin, J., Huang, Y., Zhang, J., He, A., Han, K., Zhang, H., et al. (2018) · Journal of Molecular Medicine · doi:10.1007/s00109-018-1711-0 · Cited by 58
Time Dependency of Prognostic Factors in Patients with Stage II Osteosarcomas
Kim, M. S., Cho, W. H., Song, W. S., Lee, S., & Jeon, D. (2007) · Clinical Orthopaedics and Related Research · doi:10.1097/blo.0b013e318142b27d · Cited by 57
“for osteosarcoma is histologic response to chemotherapy.(3,7) We often encounter patients who have experi-”
BackgroundResultLin, C. H., Guo, Y., Ghaffar, S., McQueen, P., Pourmorady, J. S., Christ, A. B., Rooney, K., Ji, T., Eskander, R. H., Zi, X., et al. (2013) · Sarcoma · doi:10.1155/2013/147541 · Cited by 57
“Prognostic factors for OS include tumor site and size, primary metastases, response to chemotherapy and surgical remission [2, 3].”
BackgroundZhang, L., Wang, Y., Zhang, L., Xia, X., Chao, Y., He, R., Han, C., & Zhao, W. (2019) · Cancer Letters · doi:10.1016/j.canlet.2019.01.046 · Cited by 57
Prognosis of Radiation-induced Bone Sarcoma is Similar to Primary Osteosarcoma
Shaheen, M. F., Deheshi, B. M., Riad, S., Werier, J. A., Holt, G. E., Ferguson, P. C., & Wunder, J. S. (2006) · Clinical Orthopaedics and Related Research · doi:10.1097/01.blo.0000229315.58878.c1 · Cited by 57
“Treatment of primary osteosarcoma or other spindle cell sarcomas of bone with chemotherapy and surgery is associated with 50–80% overall survival rates.(3,32) Most reports indicate RISB are more aggressive and have a worse prognosis than primary osteosarcoma or other bone sarcomas.”
BackgroundMartin, J. W., Chilton‐MacNeill, S., Koti, M., van Wijnen, A. J., Squire, J. A., & Zieleńska, M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0095843 · Cited by 56
“Unfavorable response, corresponding to a bad prognosis, is indicated by less than 90% estimated necrosis of the tumor following neo-adjuvant chemotherapy [1].”
BackgroundInfluentialBian, Y., Zhao, K., Hu, T., Tan, C., Liang, R., & Weng, X. (2024) · Advanced Science · doi:10.1002/advs.202403791 · Cited by 56
Perioperative chemotherapy in the treatment of osteosarcoma: a 26-year single institution review
O'Kane, G. M., Cadoo, K. A., Walsh, E. M., Emerson, R., Dervan, P. A., O’Keane, C., Hurson, B., O'Toole, G. C., Dudeney, S., Kavanagh, E. C., et al. (2015) · Clinical Sarcoma Research · doi:10.1186/s13569-015-0032-0 · Cited by 55
“Since the incorporation of chemotherapy, multimodality treatment has improved survival to approximately 70% at 5 years with little improvement in the last two decades [4, 6, 7].”
BackgroundInfluentialGemoll, T., Epping, F., Heinrich, L., Fritzsche, B., Roblick, U. J., Szymczak, S., Hartwig, S., Depping, R., Bruch, H., Thorns, C., et al. (2015) · Oncotarget · doi:10.18632/oncotarget.4140 · Cited by 56
“Despite efforts in new therapeutic modalities based on neoadjuvant chemotherapy followed by surgical resection and postoperative chemotherapy, overall survival rates rarely exceed 60-65% [3-5].”
Saab, R. H., Rao, B. N., Galindo, C. R., Billups, C. A., Fortenberry, T. N., & Daw, N. C. (2005) · Cancer · doi:10.1002/cncr.20959 · Cited by 56
Late relapse of osteosarcoma: Implications for follow‐up and screening
Strauss, S. J., McTiernan, A., & Whelan, J. (2004) · Pediatric Blood & Cancer · doi:10.1002/pbc.20154 · Cited by 59
“Prognostic factors that determine survival following relapse of disease include the disease-free interval, site of relapse, and whether patients are able to attain complete surgical excision of disease [9,13].”
Backgroundde Nigris, F., Zanella, L., Cacciatore, F., Chiara, A. D., Fazioli, F., Chiappetta, G., Apice, G., Infante, T., Monaco, M., Rossiello, R., et al. (2011) · BMC Cancer · doi:10.1186/1471-2407-11-472 · Cited by 56
“This is due to the development of resistance to multiple types of chemotherapy and radiotherapy [2-4].”
BackgroundResultPrognostic markers in osteosarcoma
Bakhshi, S., & Radhakrishnan, V. S. (2010) · Expert Review of Anticancer Therapy · doi:10.1586/era.09.186 · Cited by 56
Circulating biomarkers in osteosarcoma: new translational tools for diagnosis and treatment
Raimondi, L., Luca, A. D., Costa, V., Amodio, N., Carina, V., Bellavia, D., Tassone, P., Pagani, S., Fini, M., Alessandro, R., et al. (2017) · Oncotarget · doi:10.18632/oncotarget.19852 · Cited by 56
“Furthermore, to counteract the possible presence of occult micro-metastasis at diagnosis, routine use of systemic adjuvant chemotherapy increases and improves patient survival [25, 26].”
BackgroundZhuang, H., Lin, R., Liu, Y., Zhang, M., Zhai, D., Huan, Z., & Wu, C. (2019) · ACS Biomaterials Science & Engineering · doi:10.1021/acsbiomaterials.9b01095 · Cited by 55
Adjuvant therapy of osteosarcoma—A Phase II trial
Zalupski, M. M., Rankin, C. J., Ryan, J. R., Lucas, D. R., Muler, J. H., Lanier, K. S., Budd, G. T., Biermann, J. S., Meyers, F. J., & Antman, K. H. (2004) · Cancer · doi:10.1002/cncr.20021 · Cited by 56
“The median age of study participants was 22 years, and 25% of those enrolled were age 30 years, a known adverse prognostic factor.(4,25) Although the current study did not include children age 12 years, and the power to detect such an effect was limited by”
BackgroundZhu, H., Tang, J., Tang, M., & Cai, H. (2013) · Diagnostic Pathology · doi:10.1186/1746-1596-8-183 · Cited by 55
“predominately arises in bone during periods of rapid growth and has a predilection to affect adolescents and young adults, and if untreated it is fatal [2].”
BackgroundVásquez, L., Tarrillo, F., Oscanoa, M., Maza, I., Gerónimo, J., Paredes, G., Silva, J. M., & Sialer, L. (2016) · Frontiers in Oncology · doi:10.3389/fonc.2016.00022 · Cited by 55
“Studies in developed countries mention survival rates of 70–75% in localized disease (4, 6, 34, 35).”
BackgroundYang, L., Ge, D., Chen, X., Qiu, J., Yin, Z., Zheng, S., & Jiang, C. (2018) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2018.05.198 · Cited by 55
Fukushima, T., Ogura, K., Akiyama, T., Takeshita, K., & Kawai, A. (2018) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-018-2217-1 · Cited by 55
Nomogram application to predict overall and cancer-specific survival in osteosarcoma
Zheng, W., Huang, Y., Chen, H., Wang, N., Xiao, W., Liang, Y., Jiang, X. M., Su, W., & Wen, S. (2018) · Cancer Management and Research · doi:10.2147/cmar.s177945 · Cited by 55
“With regard to the tumor stage at diagnosis, several groups reported that osteosarcoma patients with metastases have a significantly worse survival prognosis.(1,10,36,37) Patients with metastases may have better relative outcomes if they had only lung metastases and underwent curative metastasectomy.”
BackgroundThe regulatory functions of circular RNAs in osteosarcoma
Soghli, N., Qujeq, D., Yousefi, T., & Soghli, N. (2020) · Genomics · doi:10.1016/j.ygeno.2020.03.024 · Cited by 55
Management and outcome after local recurrence of osteosarcoma
Grimer, R. J., Sommerville, S. M. M., Warnock, D., Carter, S., Tillman, R. M., Abudu, A., & Spooner, D. A. (2005) · European Journal of Cancer · doi:10.1016/j.ejca.2004.11.012 · Cited by 56
Response of osteogenic sarcoma to neoadjuvant therapy: evaluated by 18F-FDG-PET
Ye, Z., Zhu, J., Tian, M., Zhang, H., Zhan, H., Zhao, C., Yang, D., Li, W., & Lin, N. (2008) · Annals of Nuclear Medicine · doi:10.1007/s12149-008-0147-y · Cited by 55
“A retrospective study of 1702 patients showed that treatment-induced pathological necrosis had a signifi cant correlation (P 2 ].”
BackgroundInfluential
Metadata
- Authors
- Bielack, S. S., Kempf-Bielack, B., Delling, G., Exner, G. U., Flege, S., Helmke, K., Kotz, R., Salzer-Kuntschik, M., Werner, M., Winkelmann, W., Zoubek, A., Jürgens, H., & Winkler, K.
- Affiliations
- University of Münster (DE)
- Corresponding author
- Bielack, Stefan S.
- ORCID
- Bielack, Stefan S.
- Venue
- Journal of Clinical Oncology
- Published
- 2002-02-01
- Volume
- 20
- Issue
- 3
- Pages
- 776-790
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2148077417
- Cited by
- 2,393
- References
- 61
- Citations by year
- 2026: 85 · 2025: 95 · 2024: 112 · 2023: 162 · 2022: 159 · 2021: 167 · 2020: 166 · 2019: 121 · 2018: 114 · 2017: 106 · 2016: 122 · 2015: 139 · 2014: 124 · 2013: 106 · 2012: 75
- FWCI
- 34.99
- Type
- journal article
- Language
- en
- Update notices
- new_edition (2023-09-15)
- Open access
- closed
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Sarcoma Diagnosis and Treatment
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone Tumor Diagnosis and Treatments
- Health Sciences › Medicine › Oncology › Ovarian cancer diagnosis and treatment
- Keywords
- high-grade osteosarcoma, prognostic factors, neoadjuvant chemotherapy, limb-sparing surgery, tumor location, tumor size, chemotherapy response, surgical remission, event-free survival, overall survival, histological response, patient age, sex differences
- MeSH terms
- Adolescent, Adult, Aged, Bone Neoplasms, Child, Child, Preschool, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Prognosis, Osteosarcoma, Survival Rate, Multivariate Analysis, Chemotherapy, Adjuvant
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